TY - T1的肺部动脉内膜切除术后持续运动不耐受CTEPH JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.00109 -2020欧元SP - 2000109 AU Ruigrok Dieuwertje AU - Meijboom,莉莲J . AU - Nossent以斯帖J . AU - Boonstra Anco盟——Braams纳塔莉亚J . AU - van Wezenbeek,杰西盟德曼,Frances S. AU - Marcus, J. Tim AU - Vonk Noordegraaf, Anton AU - Symersky, Petr AU - Bogaard，肺动脉内膜切除术(PEA)治疗慢性血栓栓塞性肺动脉高压(CTEPH)的最终目的是血流动力学正常化。然而，血流动力学的正常化是否转化为运动能力的正常化还不得而知。PEA后运动不耐受的发生率、决定因素和临床意义尚不清楚。我们进行了一项前瞻性分析，以确定PEA后运动不耐受的发生率，评估运动能力与(静息)血流动力学之间的关系，并寻找PEA后运动不耐受的术前预测因素。方法所有患者均在PEA术前及术后6个月进行心肺运动试验(CPET)、右心导管置管(RHC)及心脏磁共振(CMR)检查。运动不耐受定义为预测的峰值VO2<80%。判断CPET参数以确定运动受限的原因。分析运动不耐受与静息血流动力学及cmr衍生的右心室功能之间的关系。应用logistic回归分析运动不耐受的潜在术前预测因素。结果68例患者纳入最终分析。 45 patients (66%) had exercise intolerance 6 months after PEA; in 20 patients this was primarily caused by a cardiovascular limitation. The incidence of residual PH was significantly higher in patients with persistent exercise intolerance (p 0.001). However, 27 out of 45 patients with persistent exercise intolerance had no residual PH. In the multivariate analysis, preoperative transfer factor for carbon monoxide (TLCO) was the only predictor of exercise intolerance after PEA.Conclusions The majority of CTEPH patients has exercise intolerance after PEA, often despite normalisation of resting hemodynamics. Not all exercise intolerance after PEA is explained by the presence of residual PH, and lower preoperative TLCO was a strong predictor of exercise intolerance 6 months after PEA.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Ruigrok has nothing to disclose.Conflict of interest: Dr. Meijboom has nothing to disclose.Conflict of interest: Dr. Nossent has nothing to disclose.Conflict of interest: Dr. Boonstra has nothing to disclose.Conflict of interest: Dr. Braams has nothing to disclose.Conflict of interest: Dr. van Wezenbeek has nothing to disclose.Conflict of interest: Dr. de Man has nothing to disclose.Conflict of interest: Dr. Marcus has nothing to disclose.Conflict of interest: Dr. Vonk Noordegraaf reports grants from Actelion, grants from GSK, grants from Pfizer, grants from Bayer, outside the submitted work.Conflict of interest: Dr. Symersky has nothing to disclose.Conflict of interest: Dr. Bogaard reports grants from Actelion, grants from GSK, grants from Pfizer, grants from Bayer, grants from Therabel, outside the submitted work. ER -